21. Phân tích một số yếu tố tiên lượng liên quan đến kết quả điều trị bảo tồn không phẫu thuật chấn thương lách độ III - V

Abstract

The purpose of this study is to understand the predictors and risk factors affecting the outcome of conservative nonsurgical treatment of splenic trauma. This is a descriptive study of 249 patients with grade III - V splenic injury on MDCT, who were treated at Viet Duc Friendship Hospital from January 2018 to September 2022. The results showed that 243/249 cases (97.6%) were successfully managed conservatively by medical and endovascular treatment. Univariate analysis showed that transfusion volume and degree of splenic injury were two predictors of failure of conservative treatment of splenic injury (p < 0.05). In contrast, other important factors such as age, co-morbidity of abdominal and/or cranial trauma were not contraindications to conservative treatment of splenic injury (p > 0.05). Binary logistic regression analysis showed that the degree of splenic injury was the only predictor of failure of conservative nonoperative treatment (p < 0.05). As such, identifying predictors and risk factors based on a standardized plan will likely increase the success of this conservative management.